Eclectic commentary from a progressive voice in the reddest part of the red state

Tuesday, March 3, 2015

Ethical bankruptcy of hospital management

Two law suits, one in Texas and the other in New Mexico, put
the spotlight on the role of hospitals in employee or patient safety.

In New Mexico, Colleen Heild, my friend who is an
investigative reporter at the Albuquerque Journal, reports U.S. Bankruptcy
Judge Robert H. Jacobvitz ruled a hospital management company, in this case
Quorum Health Resources, “breached its duty to prevent the risk of harm to
dozens of patients of an Alamogordo hospital who were unwittingly subjected to
experimental procedures to alleviate back pain.”

The other case, which may not see a ruling for quite a
while, involves the Dallas-area nurse, Nina Pham, who contracted Ebola after
caring for Thomas Duncan at Texas Health Presbyterian Hospital. Duncan
later died. The Dallas Morning News broke the story over this past weekend and
ProPublica placed Pham’s lawsuit in a broader context — the violation of
patient privacy.

The behavior of the hospitals’ management in these stories
triggered memories of my experience during the 1960s while attending the Hospital
and Health Administration Program at the University of Iowa. And these cases brought
to mind why hospital management can be so bereft of ethics. As part of the Iowa’s
program back then, the department head, the late Gerhard Hartman, consulted with
hospitals throughout the nation. Those engagements were the basis for the
second-year masters students’ “community study,” the report and recommendations
Hartman made to his clients.

Under the supervision of doctoral students, masters
candidates would do all the research and writing of those reports. Sometimes the
project involved traveling to the community, which the team members financed
themselves. The community study team also paid for the report to be typed and
then the university department copier would print the report for presentation.

I know that Hartman never reimbursed the graduate students
for the expenses involved in the study. I doubt he reimbursed the university
for using its resources as well. In the 1970s, there were rumors that Harman
had double-dipped, billing the clients and university for the same services. No
one, of course, stood up to him at the time. The price would have been too
high. But it set the tone for the ethics in the department and I have often wondered
over the years whether it set the tone for generations of hospital administrators
who came through the Iowa program.